I cringe when Times of India reports results from a COVID19 case-series from Maharashtra- drugs are doing great. Not a word on control arm or standard of care. They should ask—and tell us—who did they compare the drug with. These numbers are confusing and distort science. 1/4 
First, #Favipiravir. Maharashtra reports that 5.5% (27/495) mildly sick COVID patients on Favipiravir died. Normally, about 98% of such patients recover. Are these results “encouraging”? Or should we be worried about the association of increased mortality with Favipiravir? 2/4
Second, #Remdesivir. The NEJM RCT showed that 7.1% on Remdesivir died compared to 11.9 % on placebo. The results lacked statistical significance. In Maharashtra, 29% (89/311) patients receiving Remdesivir died. Should we call these results promising? 3/4
Third, #Tocilizumab. In Maharashtra, 23% (73 of 333) patients on Tocilizumab died. Unless we know if the control group received dexamethasone or not, these numbers mean nothing. Who do we attribute the success to: Tocilizumab, #dexamethasone or the better standard of care? 4/4
Policymakers, researchers, newspapers and TV channels are expected to be more careful when they word and share their observations with the public. Now, it will be impossible to enrol participants in the randomized controlled trials- who would want to be in the control group?
